Monopolar return pad

ABSTRACT

A combination patient return pad and surgical smoke evacuator includes a return electrode configured to attach to a surface and a suction tube for drawing surgical smoke from a surgical site.

INTRODUCTION

The present disclosure relates generally to electrosurgical systems andmethods. More particularly, the present disclosure is directed to amonopolar return pad having a pathway for evacuating surgical smoke.

BACKGROUND

Energy-based tissue treatment is well-known in the art. Various types ofenergy (such as electrical, ultrasonic, microwave, cryogenic, heat,laser, and/or the like) are applied to tissue to achieve a desiredresult. Electrosurgery involves application of high radio frequencyelectrical current to a surgical site to cut, ablate, coagulate, seal orotherwise treat tissue. Energy-based surgical devices typically includean isolation boundary between the patient and the energy source.

In monopolar electrosurgery, the active electrode is typically part ofthe surgical instrument held by the surgeon and applied to the tissue tobe treated. One or more patient return electrodes are placed remotelyfrom the active electrode to carry the current back to the generator anddisperse current applied by the active electrode.

SUMMARY

In accordance with aspects of the disclosure, a patient return pad isprovided and includes a sheet having a bottom surface, a returnelectrode coupled to the bottom surface of the sheet and configured toreceive electrosurgical energy from an active electrode, and a suctiontube configured to be coupled to the sheet for vacuuming surgical smoke.

In aspects, the bottom surface of the sheet may include an interiorsection and an outer peripheral section at least partially surroundingthe interior section. The return electrode may be coupled to the outerperipheral section of the bottom surface.

In aspects, the suction tube may have an end portion attached to thesheet and may define an opening in communication with the interiorsection of the sheet.

In aspects, the interior section may be recessed relative to the outerperipheral section, such that the bottom surface of the sheet defines acavity therein. The opening of the end portion may be in fluidcommunication with the cavity.

In aspects, the patient return pad may further include a foam padreceived in the cavity.

In aspects, the bottom surface of the sheet may be configured to form acavity between the interior section of the bottom surface and a tissuesurface upon attaching the outer peripheral section of the bottomsurface to the tissue surface.

In aspects, the patient return pad may further include a conductiveadhesive disposed on the outer peripheral section.

In aspects, the sheet may have a front end and a rear end and may definea vacuum path from the front end toward the rear end. The suction tubemay be coupled to the rear end.

In aspects, the patient return pad may further include a return leadhaving a first end portion coupled to the return electrode and a secondend portion configured to electrically couple the return electrode to anelectrosurgical energy source.

In aspects, the return lead may extend through or over the suction tube.

In accordance with another aspect of the disclosure, a combinationpatient return pad and surgical smoke evacuator is provided and includesa housing and a return electrode. The housing defines a cavity thereinconfigured to receive suction. The return electrode is coupled to abottom surface of the housing. The return electrode has an adherent andconductive bottom surface configured to receive electrosurgical energyfrom an active electrode.

In aspects, the combination patient return pad and surgical smokeevacuator may further include a suction tube. The suction tube may havea first end portion configured to be coupled to a vacuum source and asecond end portion coupled to the housing and in fluid communicationwith the cavity for vacuuming surgical smoke through the cavity.

In aspects, the combination patient return pad and surgical smokeevacuator may further include a foam pad received in the cavity.

In aspects, the housing may have an opened front end and a rear end andmay define a vacuum path from the front end toward the rear end.

In aspects, the combination patient return pad and surgical smokeevacuator may further include a return lead having a first end portioncoupled to the return electrode and a second end portion configured toelectrically couple the return electrode to an electrosurgical energysource.

Further details and aspects of exemplary embodiments of the disclosureare described in more detail below with reference to the appendedfigures. Any of the above aspects and embodiments of the disclosure maybe combined without departing from the scope of the disclosure.

As used herein, the term “about” means that the numerical value isapproximate and small variations would not significantly affect thepractice of the disclosed embodiments. Where a numerical limitation isused, unless indicated otherwise by the context, “about” means thenumerical value can vary by ±10% and remain within the scope of thedisclosed embodiments.

BRIEF DESCRIPTION OF THE DRAWINGS

The above and other aspects, features, and advantages of the presentdisclosure will become more apparent in light of the following detaileddescription when taken in conjunction with the accompanying drawings, inwhich:

FIG. 1 is a schematic illustration of a monopolar electrosurgical systemincluding an electrosurgical generator, an electrosurgical instrument,and a patient return pad;

FIG. 2 is a perspective view illustrating the patient return pad of FIG.1;

FIG. 3 is a partial bottom view of the patient return pad of FIG. 1;

FIG. 4 is a perspective view illustrating another embodiment of apatient return pad for use in the monopolar electrosurgical system;

FIG. 5 is a front, perspective view illustrating a patient return padwith a foam pad removed;

FIG. 6 is a bottom view of a return electrode of the patient return padof FIG. 4; and

FIG. 7 is a perspective view of yet another embodiment of a patientreturn pad for use in the monopolar electrosurgical system.

DETAILED DESCRIPTION

Particular embodiments of the present disclosure are describedhereinbelow with reference to the accompanying drawings. In thefollowing description, well-known functions or constructions are notdescribed in detail to avoid obscuring the present disclosure inunnecessary detail.

A combination patient return pad and surgical smoke evacuator isprovided and includes a sheet of material configured to be positioned ona surface adjacent a surgical site, a return electrode formed with orotherwise coupled to the sheet of material, and a suction tube coupledto the sheet of material. The return electrode receives electrosurgicalenergy from an active electrode and the suction tube removes surgicalsmoke from the surgical site.

FIG. 1 illustrates an electrosurgical system 10 including anelectrosurgical energy source, such as, for example, an electrosurgicalgenerator 12, an electrosurgical instrument 14 coupled to the generator12, and a patient return pad 100 coupled to the generator 12 via areturn cable 102. The electrosurgical generator 12 may be any suitabletype of generator and may include a plurality of connectors toaccommodate various types of electrosurgical instruments (e.g.,monopolar, bipolar, and/or the like). The electrosurgical generator 12may also include a vacuum source 20 for drawing surgical smoke from asurgical site. In aspects, the vacuum source 20 and electrosurgicalgenerator 12 may be separate components.

The electrosurgical instrument 14 has one or more active electrodes (notexplicitly shown) for treating tissue of a patient P. The instrument 14may be a monopolar instrument including one or more active electrodes(such as, for example, an electrosurgical cutting probe, ablationelectrode(s), and/or the like). Electrosurgical RF energy is supplied tothe instrument 14 by the generator 12 via an active electrosurgicalcable 18, which is connected to an active output terminal, allowing theinstrument 14 to coagulate, ablate and/or otherwise treat tissue.

With reference to FIGS. 1-3, the patient return pad 100 is a combinationpatient return pad and smoke evacuator and generally includes a head104, the return cable 102, and a suction tube 106 supported by the head104. The head 104 may have a square shape, a triangular shape, or anyother suitable shape. The head 104 has an opened front end 104 a and anopened rear end 104 b. A vacuum pathway V is defined between the front104 a and rear ends 104 b of the head 104 and extends in the directiontoward the rear end 104 b.

The head 104 includes a pliable sheet 108 or surface, such as, forexample, fabric, plastic, or any other suitable material to facilitatereturn pad operation. The pliable sheet 108 of the head 104 has a topsurface 108 a, and a bottom surface 108 b configured to face and attachto a tissue surface of a patient located adjacent a surgical site. Thebottom surface 108 b of the pliable sheet 108 has an interior section110 and an outer peripheral section 112 partially surrounding theinterior section 110. The interior section 110 may be recessed relativeto the outer peripheral section 112 to define a cavity 114. As such,upon attaching the outer peripheral section 112 of the bottom surface108 b to a tissue surface (e.g., skin of a patient), the interiorsection 110 of the bottom surface 108 b is elevated above the tissuesurface to allow air (e.g., surgical smoke) to pass from the openedfront end 104 a of the head 104 to the opened rear end 104 b of the head104.

In aspects, the head 104 may include a pad 116, such as, for example, afoam pad, received in the cavity 114 to assist in maintaining the cavity114 open when the bottom surface 108 b is attached to a surface. Inaspects, the pad 116 may be fabricated from any suitable material andmay be conductive or non-conductive. The pad 116 may be coated with anadherent film, such as, for example, polyethylene. The outer peripheralsection 112 of the bottom surface 108 b of the pliable sheet 108 has anelectrically-conductive adhesive coating 118 (FIG. 3) disposed thereon.In aspects, the adhesive 118 may be a liquid, a gel, a film, or thelike.

The head 104 includes a return electrode 120 attached to the outerperipheral section 112 of the bottom surface 108 b and may have the sameshape as the outer peripheral section 112 or may extend over the outerperipheral section 112 and the entire bottom surface of the pad 116. Insome aspects, the pad 116 may be fabricated from a conductive materialso as to act as the return electrode. The return electrode 120 may be asheet, a wire, or a coating and may be made from materials that includealuminum, copper, mylar, metalized mylar or other suitable conductivematerial. The return electrode 120 may also include an insulator, glue,a conductive adhesive, gel or other material that is configured toattach the return electrode 120 to tissue and/or to facilitate thetransfer of electrosurgical energy to the patient's skin. It iscontemplated that the return electrode 120 and the outer peripheralsection 112 have a sufficient surface area to conduct electrosurgicalenergy to the patient's skin without causing damage to the skin. Thehead 104 may further include a backing 122 (FIG. 2) that covers thebottom surface 108 b of the pliable sheet 108. The backing 122 may beselectively removed (e.g., peeled) from the bottom surface 108 b toexpose the adhesive 118.

The return electrode 120 has the return lead 102 extending therefrom. Inparticular, the return lead 102, which may be a wire or a cable, has afirst end portion 102 a attached to the return electrode 120, and asecond end portion 102 b (FIG. 1) attached to the electrosurgicalgenerator 12. The return lead 102 transfers electrosurgical energyreceived by the return electrode 120 to the electrosurgical generator12.

The suction tube 106 of the patient return pad 100 has a first endportion 106 a configured to be coupled to the vacuum source 20 (FIG. 1)and a second end portion 106 b configured to be either permanentlycoupled or detachably coupled to the rear end 104 b of the head 104. Thesuction tube 106 defines a longitudinal channel 124 therethrough toallow for the passage of surgical smoke. The second end portion 106 b ofthe suction tube 106 may have a connector 126 attached thereto thatcouples the suction tube 106 to the head 104. In aspects, the second endportion 106 b of the suction tube 106 may be received in the rear end104 b of the head 104. The connector 126 extends through the open rearend 104 b of the head 104 and defines an opening 128 in fluidcommunication with the cavity 114, such that surgical smoke may passfrom the cavity 114 and into the suction tube 106 via the opening 128.The connector 126 may have a flat bottom surface 130 that is coplanarwith the outer peripheral section 112 of the bottom surface 108 b of thepliable sheet 108 to prevent air gaps from forming between the bottomsurface 108 b and a tissue surface. The return lead 102 may extendthrough the channel 124 of the suction tube 106, around the suction tube106, or run alongside of and separate from the suction tube 106.

During an electrosurgical procedure, the backing 122 of the head 104 ofthe patient return pad 100 is removed and the bottom surface 108 b ofthe pliable sheet 108 of the head 104 is placed at a location adjacentthe surgical site and in contact with tissue of a patient P (e.g.,skin). In aspects where only the vacuum function of the head 104 isdesired, the bottom surface 108 b of the pliable sheet 108 may be placedon a surgical drape or other suitable surface adjacent the surgicalsite. The adhesive 118 on the outer peripheral section 112 of the bottomsurface 108 b fixes the outer peripheral section 112 to the patient'sskin. The pad 116 of the head 104 also contacts the skin surface,whereby the interior section 110 is maintained in spaced relation fromthe skin surface and the front end 104 a of the head 104 is maintainedin an opened state. Due to the return electrode 120 being attached tothe outer peripheral section 112, the return electrode 120 is placed incontact with or otherwise electrically connected to the skin via theadhesive 118 (e.g., conductive adhesive).

The monopolar electrode of the surgical instrument 14 may be activatedto treat tissue. During treatment, the electrosurgical energy passesfrom the generator 12, through the electrosurgical instrument 14 andinto the patient P to treat the tissue. The electrosurgical energy thentravels from the tissue back to the electrosurgical generator 12 via thereturn electrode 120 in the patient return pad 100. During theprocedure, the vacuum source 20 may be activated to clear any smoke ordebris from the surgical field while the foam pad 116 prevents debrisfrom entering the cavity 114. In aspects, the vacuum source 20 may beactivated prior to treating tissue and the generation of smoke. Uponactivating the vacuum source 20, a suction pathway is generated andcarries the surgical smoke from the surgical field and into the cavity114 via the front end 104 a of the head 104. The surgical smoke passesinto the suction tube 106 via the opening 128 in the connector 126. Inthis way, the patient return pad 100 functions both as a returnelectrode for receiving electrosurgical energy from the active electrodeand as a surgical smoke evacuator. The vacuum source 20 may remain onfor a selected period of time after activation of the generator 12 hasceased.

With reference to FIGS. 4-6, another embodiment of a combination patientreturn pad and smoke evacuator 200 is illustrated and generally includesa head, such as, for example, a housing 204, a return electrode 220attached to the housing 204, and a suction tube, such as, for example,the suction tube 106 (FIG. 2) supported by the housing 204. The housing204 may have a box-shape or any other suitable shape and has an openedfront end 204 a and a closed rear end 204 b. In aspects, the front end204 a may be planar (FIG. 4) or have a curved or scooped configuration(FIG. 5) to better allow for the front end 204 a to surround a surgicalopening.

A vacuum pathway is defined between the front 204 a and rear ends 204 bof the housing 204 and extends in the direction toward the rear end 204b. The housing 204 has a top surface 208 a, a bottom surface 208 bconfigured to face a tissue surface of a patient, and a pair of sidewalls 208 c, 208 d. The housing 204 may include a pad 216, such as, forexample, a foam pad, received in a cavity 214 (FIG. 5) defined by thehousing 204 to prevent debris from entering the cavity 214. The housing204 has a vacuum connector 216 coupled to the top surface 208 a and influid communication with the cavity 214. The suction tube 106 (FIG. 2)is configured to couple to the vacuum connector 218 to fluidlycommunicate with the opened front end 204 a of the housing 204.

The return electrode 220 may be a split return electrode pad and isattached to the bottom surface 208 b of the housing 204. The returnelectrode 220 may be a sheet, a wire, or a coating and may be made frommaterials that include aluminum, copper, mylar, metalized mylar or othersuitable conductive material. The return electrode 220 has a bottomsurface 222 having coated thereon an electrically-conductive adhesive(e.g., a conductive adhesive hydrogel) or other material that isconfigured to attach the return electrode 220 to tissue. A backing (notexplicitly shown) may be provided that covers the bottom surface 222 ofthe return electrode 220. The backing may be selectively removed (e.g.,peeled) from the bottom surface 222 to expose the adhesive.

The return electrode 222 has a pair of return leads 224, 226 extendingtherefrom. In particular, the return leads 224, 226, which may be wiresor cables, have a first end portion attached to the return electrode220, and a second end portion attached to the electrosurgical generator12 (FIG. 1). The return leads 224, 226 transfer electrosurgical energyreceived by the return electrode 220 to the electrosurgical generator12. In aspects, only one return lead may be provided.

With reference to FIG. 7, yet another embodiment of a combination returnpad and smoke evacuator 300 is illustrated and generally includes ahead, such as, for example, a housing 304, a return electrode 320attached to the housing 304, a suction tube, such as, for example, thesuction tube 106 (FIG. 2) supported by the housing 304, and a perforatedfoam pad 316 supported on the return electrode 320. The housing 304 hasan opened front end portion 304 a and a closed rear end portion 304 b.The housing 304 defines a cavity (not explicitly shown) thereinconfigured to be in communication with the suction tube 106 (FIG. 2) viaa vacuum connector 318. In aspects, the vacuum connector 318 may bedirectly attached to the foam pad 316. In aspects, the housing 304 maycover an upper surface and lateral sides of the foam pad 316.

The return electrode 320 may be a flat sheet of material covering abottom surface 319 of the housing 304 and extending distally from thefront end portion 304 a. The foam pad 316 is supported on the returnelectrode 320 and covers the opened front end portion 304 a of thehousing 304. The foam pad 316 has a plurality of perforations 324defining a plurality of removable sections 323 to allow for thecustomization of the foam pad 316. The removable sections 323 mayinclude a corresponding section 325 of the return electrode 320, suchthat upon removing the removable sections 323, an opening 327 may beformed in the smoke evacuator 300. The opening 327 may be positionedover a surgical site or access opening to surround the outer peripheryof the access opening with the smoke evacuator 300.

It should be understood that the foregoing description is onlyillustrative of the present disclosure. Various alternatives andmodifications can be devised by those skilled in the art withoutdeparting from the disclosure. Accordingly, the present disclosure isintended to embrace all such alternatives, modifications and variances.The embodiments described with reference to the attached drawing figuresare presented only to demonstrate certain examples of the disclosure.Other elements, steps, methods, and techniques that are insubstantiallydifferent from those described above and/or in the appended claims arealso intended to be within the scope of the disclosure.

What is claimed is:
 1. A patient return pad, comprising: a sheet havinga bottom surface; a return electrode coupled to the bottom surface ofthe sheet and configured to receive electrosurgical energy from anactive electrode; and a suction tube configured to be coupled to thesheet for vacuuming surgical smoke, the bottom surface of the sheetincluding an interior section and an outer peripheral section at leastpartially surrounding the interior section, the return electrode beingcoupled to the outer peripheral section of the bottom surface, whereinthe suction tube has an end portion attached to the sheet and definingan opening in communication with the interior section of the sheet. 2.The patient return pad according to claim 1, wherein the interiorsection is recessed relative to the outer peripheral section, such thatthe bottom surface of the sheet defines a cavity therein, the opening ofthe end portion in fluid communication with the cavity.
 3. The patientreturn pad according to claim 2, further comprising a foam pad receivedin the cavity.
 4. The patient return pad according to claim 1, whereinthe bottom surface of the sheet is configured to form a cavity betweenthe interior section of the bottom surface and a tissue surface uponattaching the outer peripheral section of the bottom surface to thetissue surface.
 5. The patient return pad according to claim 1, furthercomprising a conductive adhesive disposed on the outer peripheralsection.
 6. The patient return pad according to claim 1, wherein thesheet has a front end and a rear end and defines a vacuum path from thefront end toward the rear end, the suction tube coupled to the rear end.7. The patient return pad according to claim 1, further comprising areturn lead having a first end portion coupled to the return electrodeand a second end portion configured to electrically couple the returnelectrode to an electrosurgical energy source.
 8. The patient return padaccording to claim 7, wherein the return lead extends through or overthe suction tube.
 9. A combination patient return pad and surgical smokeevacuator, comprising: a housing defining a cavity therein configured toreceive suction, the housing having a bottom surface; a return electrodecoupled to the bottom surface of the housing, the return electrodehaving an adherent and conductive bottom surface configured to receiveelectrosurgical energy from an active electrode; and a suction tubehaving a first end portion configured to be coupled to a vacuum sourceand a second end portion coupled to the housing and in fluidcommunication with the cavity for vacuuming surgical smoke through thecavity.
 10. The combination patient return pad and surgical smokeevacuator according to claim 9, further comprising a foam pad receivedin the cavity.
 11. The combination patient return pad and surgical smokeevacuator according to claim 9, wherein the housing has an opened frontend and a rear end and defines a vacuum path from the front end towardthe rear end.
 12. The combination patient return pad and surgical smokeevacuator according to claim 9, further comprising a return lead havinga first end portion coupled to the return electrode and a second endportion configured to electrically couple the return electrode to anelectrosurgical energy source.